title: Task shifting redefined: removing social and structural barriers to improve delivery of HIV services for people who inject drugs.
abstract: HIV infection among people who inject drugs (IDU) remains a major global public health challenge. However, among IDU, access to essential HIV-related services remains unacceptably low, especially in settings where stigma, discrimination, and criminalization exist. These ongoing problems account for a significant amount of preventable morbidity and mortality within this population, and indicate the need for novel approaches to HIV program delivery for IDU. Task shifting is a concept that has been applied successfully in African settings as a way to address health worker shortages. However, to date, this concept has not been applied as a means of addressing the social and structural barriers to HIV prevention and treatment experienced by IDU. Given the growing evidence demonstrating the effectiveness of IDU-run programs in increasing access to healthcare, the time has come to extend the notion of task shifting and apply it in settings where stigma, discrimination, and criminalization continue to pose significant barriers to HIV program access for IDU. By involving IDU more directly in the delivery of HIV programs, task shifting may serve to foster a new era in the response to HIV/AIDS among IDU.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: Lianping
authors.initials: L
authors.lastname: Ti
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000600:supply & distribution / Q000627:therapeutic use; D003695:Delivery of Health Care / Q000458:organization & administration*; D015658:HIV Infections / Q000517:prevention & control*; D040261:Harm Reduction; D006801:Humans; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000600:supply & distribution; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents